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Aims: To investigate the association between multimorbidity and urinary incontinence (UI) among community living older adults with complex needs in sex‐specific crude and adjusted analyses. Methods: Since 2012 in Aotearoa | New Zealand (NZ) all community‐living older people with complex needs who require publicly funded assistance undergo a comprehensive standardized geriatric needs assessment using the interRAI‐HC instrument. Consenting adults aged ≥65 years who undertook this assessment between July 5, 2012 and December 31, 2020 were investigated. Multimorbidity was defined as having ≥2 chronic conditions. Recent bladder incontinence episodes were elicited and UI dichotomized into continent and incontinent groups. Results: The study included 140 401 participants with an average age of 82.0 years (range: 65–107 years), of whom 85 746 (61.1%) were female. Overall, 36 185 (42.2%) females and 17 988 (32.9%) males reported UI. Participants had a median of 3 (range: 0–12) chronic conditions, with 109 135 (77.9%) classified as having multimorbidity. In adjusted modified Poisson regression analyses, the prevalence ratio for UI was 1.21 (95% confidence interval [CI]: 1.19, 1.24) times higher in females and 1.18 (95% CI: 1.14, 1.22) times higher for males with multimorbidity compared to those without multimorbidity. Conclusions: Although significant, the estimated sex‐specific effect sizes were modest for the association between multimorbidity and UI in this population. However, despite using the comprehensive interRAI‐HC instrument, several potentially core chronic conditions were not adequately captured. Although increasingly recognized as an important and growing public health issue, capturing all relevant chronic conditions challenges many epidemiological investigations into multimorbidity. [ABSTRACT FROM AUTHOR]

Objective: To investigate the impact of New Zealand's (NZ) first wave of COVID‐19, which included a nationwide lockdown, on the health and psychosocial well‐being of Māori, Pacific Peoples and NZ Europeans in aged residential care (ARC). Methods: interRAI assessments of Māori, Pacific Peoples and NZ Europeans (aged 60 years and older) completed between 21/3/2020 and 8/6/2020 were compared with assessments of the same ethnicities during the same period in the previous year (21/3/2019 to 8/6/2019). Physical, cognitive, psychosocial and service utilisation indicators were included in the bivariate analyses. Results: A total of 538 Māori, 276 Pacific Peoples and 11,322 NZ Europeans had an interRAI assessment during the first wave of COVID‐19, while there were 549 Māori, 248 Pacific Peoples and 12,367 NZ Europeans in the comparative period. Fewer Māori reported feeling lonely (7.8% vs. 4.5%, p = 0.021), but more NZ Europeans reported severe depressive symptoms (6.9% vs. 6.3%, p = 0.028) during COVID‐19. Lower rates of hospitalisation were observed in Māori (7.4% vs. 10.9%, p = 0.046) and NZ Europeans (8.1% vs. 9.4%, p < 0.001) during COVID‐19. Conclusions: We found a lower rate of loneliness in Māori but a higher rate of depression in NZ European ARC populations during the first wave of COVID‐19. Further research, including qualitative studies with ARC staff, residents and families, and different ethnic communities, is needed to explain these ethnic group differences. Longer‐term effects from the COVID‐19 pandemic on ARC populations should also be investigated. [ABSTRACT FROM AUTHOR]

Objective: To identify factors associated with caregiver distress among home care clients in New Zealand. Methods: The cohort consisted of 105,978 community‐dwelling people aged 65 years or older requiring home care services in New Zealand who had at least one informal caregiver. Bivariate and multivariable logistic regression analyses were used to identify factors associated with caregiver distress. Results: Variables associated with risk of caregiver distress included Depression Rating Scale score, aggressive behaviour symptoms, primary informal caregiver relationship to patient, Cognitive Performance Scale score, Changes in Health, End‐stage disease, and Signs and Symptoms Scale score, informal care time, secondary informal caregiver relationship to care recipient, activities of daily living hierarchy scale score and any hospitalisation. Conclusions: The study has identified important characteristics that are associated with caregiver stress. These results suggest that caregiver distress can be relieved by promoting protective factors and aiming to reduce risk factors among home care clients in New Zealand. [ABSTRACT FROM AUTHOR]